Individual provider Active NPI

Cynthia Jeannette Martins, NP

  • Gerontology Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1891167995
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
288682 Issued in NC
Practice address
1709 S 16TH St Ste a
Wilmington, NC 28401-6491
Phone
(910) 452-8633
Fax
(910) 452-8569
NPI assigned
Oct 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5008856 NC
Gerontology Nurse Practitioner 363LG0600X RN218621 GA
Gerontology Nurse Practitioner 363LG0600X 288682 NC Primary

Addresses

Primary practice location

1709 S 16TH St Ste a
Wilmington, NC 28401-6491

Mailing address

PO Box 15109
Wilmington, NC 28408-5109
Phone (910) 392-2525

Other practice location 1

2131 S 17th St
Wilmington, NC 28401-7407
Phone (910) 667-2606

Other identifiers 1

IdentifierTypeStateIssuer
288682OtherNCNC LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161114001562 NC Practitioner - Nurse Practitioner 4981904794 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group Coastal Region LLCGroup PAC ID 2860809936, 577 clinicians

Practice addresses (Care Compare)

2131 S 17TH St
Wilmington, NC 28401-7407
Phone (910) 667-3000

Hospital & facility affiliations

  • Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141
  • Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158
  • J Arthur Dosher Memorial Hospital Hospital, Southport, NC, CCN 341327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5008856NCMDNurse Practitioner
RN218621GAMDGerontology Nurse Practitioner
288682NCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
NMG Health Services LLC CurrentSince Jul 5, 2024 Accepting new patients
Senior Health Associates, P.a. CurrentSince Aug 27, 2016 Accepting new patients
Novant Health Medical Group Coastal Region, LLC CurrentSince Jul 5, 2024 Accepting new patients
Archbold Medical Group, Inc. Past Accepting new patients
New Hanover Medical Group PA Past Accepting new patients

Locations

507 E Fremont St
Burgaw, NC 28425
Phone (910) 259-5451

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

1709 S 16th St
Ste A
Wilmington, NC 28401
Phone (910) 452-8633

1984 S 16th St
Ste 1
Wilmington, NC 28401
Phone (910) 452-8633

Interoperability endpoints

  • Direct secure messaging: cmcgahee1249163@direct.novanthealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1891167995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15109",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284085109",
            "telephone_number": "910-392-2525",
            "fax_number": "910-392-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 S 16TH ST STE A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016491",
            "telephone_number": "910-452-8633",
            "fax_number": "910-452-8569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2131 S 17th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284017407",
            "country_code": "US",
            "telephone_number": "910-667-2606",
            "fax_number": "910-815-5698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINS",
        "first_name": "CYNTHIA",
        "middle_name": "JEANNETTE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-28",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5008856",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN218621",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "288682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC LICENSE",
            "identifier": "288682",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.